Individual provider Active NPI

Srikanth Papisetti, DDS

  • General Practice Dentistry
  • Lubbock, TX
National Provider Identifier
1649525171
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11810 Issued in CT
Practice address
2402 19TH St
Lubbock, TX 79401-4414
Phone
(888) 988-4066
Fax
(847) 496-7603
NPI assigned
Jul 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28263 TX
General Practice Dentistry 1223G0001X 11810 CT Primary

Addresses

Primary practice location

2402 19TH St
Lubbock, TX 79401-4414

Mailing address

2050 E Algonquin Rd
Suite 610
Schaumburg, IL 60173-4144
Phone (888) 988-4066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11810CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental Lubbock PLLC General Practice PastSince Jun 27, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1649525171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "address_2": "SUITE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734144",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 19TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794014414",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPISETTI",
        "first_name": "SRIKANTH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-20",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28263",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.